Aim The aim of this study was to determine the incidence of (Healthcare-associated infection) HAI, causative organisms, associated risk factors in a neonatal intensive care unit in Turkey.

Methods A prospective cohort study was conducted on patients admitted to the neonatal intensive care unit (NICU) from July 2011 to June 2012. The criteria that were used to diagnose infection were in accordance with the Centres for Disease Control and Prevention. The incidence, causative organisms, risk factors and mortality of healthcare-associated infections were assessed.

Results The study included 352 patients, 37 of these developed HAIs, totaling 60 HAI episodes. Overall HAI patient rate was 17.04%, and 11.51 HAIs per 1000 NICU days. The most frequent HAIs were bloodstream infections (70%) and nosocomial pneumonia (18.3%). The central venous catheter/umblical catheter-related bloodstream infections (CVC/UC BSIs) rate was 18.3/1,000 catheter days; the ventilator-associated pneumonia (VAP) rate was 13.6/1,000 ventilator days; and the catheter-associated urinary tract infections rate found was 14.9/1,000 catheter days. Prematurity, gestational age less than 32 weeks, birth weight < 1500 g, mechanical ventilation, use of CVC/UC, use of urinary catheter, and total parenteral nutrition appeared to be associated with a significantly higher risk of HAI (p ≤ 0.05). The most frequent pathogens were Enterobacter spp. (18.5%) and Acinetobacter baumannii (13.8%). Overall mortality rate in neonates was 3.9%, and the mortality rate in neonates with HAI was 10.8%.

Conclusions Healthcare-associated infection rates of our NICU were higher than international standards. The decrement of risk factors in newborns would help to improve the outcome.